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Did mental illness fuel Wisconsin massacre -- or was it terrorism?

Wade Michael Page, the gunman who ended six lives in Wisconsin and was then shot to death by police, was a man who harbored contemptible racist beliefs.  He wore a tattoo that referred to white supremacy.  He played in a skinhead heavy metal band.  He once reportedly possessed an application to join the Ku Klux Klan.  Yet all that may not be why he killed people.

Many, many people--regrettably--harbor racist, even extremist views and don't walk into buildings intent on carnage.

As could be the case with Colorado shooter James Holmes, mental illness, combined with our broken mental health care system, may turn out to be the culprit in Wisconsin.

While Page had almost no criminal history, a telling moment occurred in 1998. Although he had joined the military in 1992 and been assigned to psychological operations--an exclusive department that develops and deploys intelligence information used for psychological effect (propaganda)--he was dismissed from the army during 1998, and received a discharge "under other than honorable conditions." 

The reasons why Page was not honorably discharged, just like the reasons why James Holmes withdrew from the University of Colorado, must be made known.  Because if both men were displaying signs of a mental disorder, and if both men were then cut loose from the organizations with which they were affiliated (the military, for one; a university, for the other), then a lack of followup would amount to those organizations washing their hands of these psychologically disordered, potentially dangerous men, without due care being taken to protect the rest of us from them.

There are many among us who are so vulnerable, so fragile, that losses we would be pained by, but move on from, lead them to kill themselves, or others, or both.

At present, our mental health care system is so fractured, with followup so unreliable, information so scattered and authority granted to psychiatrists so meager, that those with delusions, even those who have expressed the desire and intent to kill others, falling through the cracks isn't the exception; it's the rule.

According to some reports, Wade Michael Page had recently broken up with his girlfriend.  And while losing a romantic partner isn't enough to stoke the flames of violence for most people, it can be for those whose minds already teeter close to the brink of chaos, due to underlying mental illness.  Because some of those people actually harbor intense fears, including the fear of being worthless and unlovable and destined for complete and utter isolation, forever.  And for those individuals, the loss of a girlfriend or a marriage can bring them to project their sense of desolation and destruction on others--as if, unable to bear the full weight of their grief and self-loathing,  they make their sense of having been deadened and decimated contagious.

If Wade Michael Page hated people of color, I promise you that was his unconscious psychological strategy to avoid hating himself--the broken child inside him who had lost his mother at age 3, and had found a parent in the U.S. military, only to be dismissed from that "family."  And for Mr. Page, if mentally ill, being told he was not loved by the woman who had once told him that she did love him, could, indeed, be enough to make him see only darkness lying ahead, and create that bleak landscape himself.

There are many among us who are so vulnerable, so fragile, that losses we would be pained by, but move on from, lead them to kill themselves, or others, or both.

I lost a close friend to murder back in 1990.  His killer, John Kappler, Jr., MD, was a mentally ill anesthesiologist who had fallen on hard times financially.  He plowed his car into my buddy, who was jogging in a park.  The two men had never met.  "I know it may seem odd to believe that a man would kill another man, simply because he feels low in his self-esteem, but that's exactly what happened," he later told investigators.  Tellingly, Kappler had been dismissed from a California hospital after displaying bizarre, destructive behavior, without enough psychiatric followup.  

This pattern--of institutions ridding themselves of those who raise serious psychiatric concerns, often without even knowing what to do next to ensure the public's safety (or simply not doing it)--must end.  And it could end with a national initiative to beef up outreach to the most worrisome individuals among us (from a psychological perspective), while greatly enhancing lines of communication between community mental health centers, hospitals and all licensed mental health care professionals via electronic record-keeping. Creating mechanisms in every state to enforce outpatient treatment of dangerous individuals (which is now possible only in some states), is also essential.

Curtailing gun rights, by the way, is a mistaken strategy to deal with the violent, mentally ill.  It misses the root cause.  My friend was killed with a car. Page and Holmes could have used makeshift bombs if they couldn't use firearms.  

Wade Michael Page may have "hated" others and wanted them dead, but that hatred could turn out to be a sign of underlying mental illness. If so, his acting upon that hatred with horrible violence, may have been a moment of psychiatric significance having nothing to do with domestic terrorism and everything to do with the terrifying thoughts and feelings visited upon him by the demons inhabiting his own psyche.

Dr. Keith Ablow is a psychiatrist and member of the Fox News Medical A-Team. Dr. Ablow can be reached at info@keithablow.com.